Vaginal cancer

Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist

What is vaginal cancer?

Cancer originating in the vagina is a rare disease, accounting for less than 1 per cent of cancers in women.

Many cancers involving the vagina have actually spread from adjacent tissues, usually from the uterus (womb) or cervix (neck of the womb).

Vaginal cancer is very rare among women of less than 50 years of age and the average age of a woman at diagnosis is 60 to 65.

What are the symptoms of vaginal cancer?

There aren't many clear symptoms. If you have a bloody discharge and bleeding during sexual intercourse or if you experience bleeding from the vagina after the menopause you should always be examined by your doctor or gynaecologist.

Sometimes vaginal cancer develops silently, and is discovered during examination for another reason, such as cervical screening (smear test).

How is vaginal cancer diagnosed?

Vaginal cancer arises from the lining cells of the vagina – which is covered in a type of cell called squamous epithelium. It can therefore be detected visually, using a magnifying instrument called a colposcope. This is carried out by a gynaecologist in a short examination which is much like an ordinary smear test.

A biopsy is always necessary to confirm the diagnosis.

Further tests such as scans can also be used to determine the extent to which the cancer has already spread, which is known as the stage of the cancer.

Stage 1 cancer is limited to the wall of the vagina.

Stage 2 cancer has spread through the vaginal wall but has not extended outwards into the tissues of the pelvis.

Stage 3 and 4 cancer is that which has reached either the bladder or lower bowel (rectum) or which has spread more widely, including outwards into the pelvis.

How is vaginal cancer treated?

Surgery to remove a part or the whole of the vagina is usually necessary. Technically, it can be a complicated operation for the surgeon because the vagina lies so close to the bladder at the front, and the bowel at the back.

This type of surgery is only performed by specially trained gynaecologists in a small number of hospitals in the UK.

Radiotherapy may also be necessary.

What is the outlook?

As with most cancers, the long-term outlook depends on many factors, the most important of which is the stage of the disease when it is diagnosed. It is also modified by the fact that it is mostly older women who have the condition.

About 70 per cent of women will still be alive five years after treatment for stage 1 vaginal cancer but this falls to 15-20 per cent for stage 4.

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